Percutaneous biodegradable stent placement for treating benign biliary strictures: a systematic review

Purpose: To assess whether safety profile and treatment success of percutaneous biodegradable biliary stent placement are competitive with traditional treatment options for treatment of benign biliary strictures.

Materials and methods: PubMed and EMBASE were systematically reviewed for articles reporting percutaneous biodegradable stent placement for treating benign biliary strictures. Databases were searched for articles until December 2023, with the earliest included article dating from April 2016. Treatment outcome was assessed by evaluating outcomes described in the articles included, including technical success of stent placement, migration rates, restenosis rates, time to restenosis and biochemical liver panel measures. Stent safety was assessed by looking at stent placement related adverse events and occurrence of cholangitis post-placement.

Results: 7 out of 39 studies in the primary search met the inclusion criteria and were further analyzed. All included studies were cases series, totaling 323 stent placements. High rates of technical success were observed (98-100%). Bile duct patency rates following biodegradable stent placement ranged from 94% (3 months follow-up) to 72% (60 months follow-up). The most frequently reported adverse event was hemobilia, followed by fever and pain.

Conclusion: Available literature reports high technical success in initial placement of biodegradable stents for benign biliary strictures and the technique seems safe. Further investigation with comparison arms is warranted to establish this technique as the preferred management for benign biliary strictures.